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MEGUMI IKEDA MITCHELL MS, ATC/LAT

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1760051783

Individual Registrant:
 MEGUMI IKEDA MITCHELL MS, ATC/LAT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
21630 STATE HIGHWAY 59 S  ROBERTSDALE, AL 36567-6710 US
Tel: 251-947-4154  Fax: 251-947-2666

Contact information for business:
14658 SILVER OAKS LOOP  SILVERHILL, AL 36576-3741 US
Tel: 251-600-9448  Fax: --

Registration Information:
NPI: 1760051783
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
AL1339

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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